Plasma proprotein convertase subtilisin/kexin type 9 inhibitors and cataract risk: A systematic review and meta-analysis

Arch Soc Esp Oftalmol (Engl Ed). 2019 Feb;94(2):75-80. doi: 10.1016/j.oftal.2018.11.003. Epub 2018 Nov 30.
[Article in English, Spanish]

Abstract

Background: The marked decrease in LDL-C levels produced by the inhibitors of the plasma proprotein convertase subtilisin/kexin type 9 (iPCSK9) could be associated with an increased risk of cataracts.

Methods: A meta-analysis was performed that included randomised clinical trials controlled with iPCSK9, alone, or in combination with other lipid-lowering drugs, which reported new cases of cataracts, by searching PubMed/Medline, databases of EMBASE and Cochrane Clinical Trials. A fixed-effect model was used, and a meta-regression was carried out evaluating the relationship between intra-treatment LDL-C and the risk of developing cataracts.

Results: Five eligible studies of iPCSK9 including 83,492 patients were taken into account for the analysis, and 531 new cases of cataracts in iPCSK9 group vs. 532 in placebo group were diagnosed. The iPCSK9 therapy was not associated with an increased risk of cataracts [OR: 0.96, 95% CI: 0.85-1.08; P=.86, I2: 0%]. Likewise, no significant association was found between on-treatment LDL-C levels, differences between study arms, and new cases of cataracts.

Conclusion: In this analysis, the use of iPCSK9 was not associated with an increased risk of cataracts.

Keywords: Cataracts; Cataratas; Inhibidores de la proproteína convertasa plasmática subtilisina kexina tipo 9; Inhibitors of plasma proprotein convertase subtilisin/kexin type 9; Meta-analysis; Metaanálisis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Anticholesteremic Agents / adverse effects*
  • Anticholesteremic Agents / therapeutic use
  • Cataract / epidemiology
  • Cataract / etiology*
  • Cholesterol / metabolism
  • Cholesterol, LDL / metabolism
  • Controlled Clinical Trials as Topic
  • Epithelial Cells / metabolism
  • Humans
  • Lens, Crystalline / metabolism
  • PCSK9 Inhibitors*
  • Protease Inhibitors / adverse effects*
  • Protease Inhibitors / therapeutic use
  • Randomized Controlled Trials as Topic
  • Research Design
  • Risk

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Anticholesteremic Agents
  • Cholesterol, LDL
  • PCSK9 Inhibitors
  • Protease Inhibitors
  • bococizumab
  • Cholesterol
  • PCSK9 protein, human
  • evolocumab
  • alirocumab